Newark Public Schools Office of Extended School Day Programs
Elementary Basketball League
I, ___________________________________________ the parent of __________________________________________
Parent/guardian name Student name
at _____________________________________ School, do grant my permission for my son/daughter to
Name of school
participate in the Elementary Basketball League that is conducted by the Newark Public Schools Office
of Extended School Day Programs and attend all affiliated trips for ___________________ season.
I understand that my child’s continued participation in the Office of Extended School Day Programs
Elementary Basketball League is contingent on my child’s proper conduct and adherence to the league’s
policies and procedures during practices, on buses, and at the games.
My child agrees to adhere to the rules and regulations and the student code of conduct of the Newark
Public Schools during any trips. Neither the district nor any of its employees shall assume any
responsibility for any intentional conduct of the student that results in a claim arising out of any trip. All
claims for intentional conduct are hereby waived. The undersigned will indemnify and save harmless
the District, and its employees, from all liability for claims arising out of intentional and/or contributory
negligent conduct of the student and as against the district and its agents and employees. “Trip”
includes the period between the time when the pupil leaves the school and returns to the school.
Street address, city and state
Please return this form to your child’s school.